Healthcare Provider Details

I. General information

NPI: 1003264201
Provider Name (Legal Business Name): FELICIA CARNEVALE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 RIVIERA ST STE D
VENICE FL
34285
US

IV. Provider business mailing address

517 RIVIERA ST STE D
VENICE FL
34285-2827
US

V. Phone/Fax

Practice location:
  • Phone: 941-244-9524
  • Fax: 941-244-9526
Mailing address:
  • Phone: 941-244-9524
  • Fax: 941-244-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9311825
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9311825
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: